Archives De Pediatrie最新文献

{"title":"Preliminary proposals for the follow-up of infants born to mothers with cystic fibrosis treated with CFTR modulators during the first two years of life","authors":"Philippe Reix ,&nbsp;Camille Audousset ,&nbsp;Emmanuelle Girodon ,&nbsp;Isabelle Sermet Gaudelus ,&nbsp;Sophie Gautier","doi":"10.1016/j.arcped.2025.03.005","DOIUrl":"10.1016/j.arcped.2025.03.005","url":null,"abstract":"<div><div>The number of pregnancies in women with cystic fibrosis (CF) has significantly increased in recent years, leading to a corresponding rise in the number of healthy infants exposed to cystic fibrosis transmembrane conductance regulator modulator (CFTRm) such as elexacaftor-tezacaftor-ivacaftor (ETI) or Kaftrio/Kalydeco® (K/K) triple therapy. Currently, data on the immediate outcomes for these children is reassuring; however, some cases of abnormal liver tests and cataracts have been reported in a few newborns indirectly exposed to ETI in utero or postnatally. Long-term neurodevelopment remains a concern that requires further investigation.</div><div>A working group from the Société Française de la Mucoviscidose has developed recommendations for monitoring these children during the first two years and beyond. Given the increasing number of infants born to mothers taking CFTR modulators, as well as questions regarding their immediate care during the maternity stay and the feasibility of breastfeeding, it is crucial for pediatricians to be aware of these recommendations, which are based on a comprehensive review of the literature.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 344-350"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Much ado about … the fetal heart examination during the first trimester.What to expect from the new French obstetrical imaging guidelines?","authors":"Daniela Laux ,&nbsp;Alexandre J. Vivanti","doi":"10.1016/j.arcped.2025.05.006","DOIUrl":"10.1016/j.arcped.2025.05.006","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 285-287"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for mountain travel and altitude acclimation in pediatric populations: a French Delphi study","authors":"Clémence Rascle ,&nbsp;Pauline Connan ,&nbsp;Corentin Tanné","doi":"10.1016/j.arcped.2025.05.007","DOIUrl":"10.1016/j.arcped.2025.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>To develop recommendations for mountain travel and altitude acclimation for children under 3 years old by convening a committee of experts.</div></div><div><h3>Methods</h3><div>Using the DELPHI method, we collected proposals via email from professionals specializing in altitude and related pathologies. Experts were asked about the maximum suggested altitude and specific recommendations.</div></div><div><h3>Results</h3><div>Sixteen experts participated in the study. The main recommendations included a maximum altitude of 2000 meters for children under 1 year old and 2500 meters for children under 3 years old, a gradual ascent with stops every 500 meters, and careful monitoring of the child's reactions. Absolute contraindications were noted for cable car ascents in children under 1 year old, with relative contraindications for those under 3 years old. It was also recommended to consult a doctor before traveling to high altitudes if the child has a risk-related pathology and to limit winter outdoor activities to short durations with appropriate clothing.</div></div><div><h3>Conclusion</h3><div>This survey revealed a consensus on the recommended maximum travel altitude for children and provided various guidelines to mitigate the effects of altitude.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 288-294"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-compliance with post-discharge vitamin D intake guidelines: an observational study in an overseas French maternity ward","authors":"Mathis Thia ,&nbsp;Simon Lorrain ,&nbsp;Magali Richard ,&nbsp;Alexandre Lapillonne ,&nbsp;Silvia Iacobelli","doi":"10.1016/j.arcped.2025.04.005","DOIUrl":"10.1016/j.arcped.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Studies in tropical countries revealed a high prevalence of vitamin D insufficiency. The French recommendations did not differentiate between overseas and mainland areas in terms of vitamin D intake. However, the prevalence of vitamin D supplementation in infants in the French overseas territories is unknown.</div></div><div><h3>Aims</h3><div>The primary objective of the study was to assess the prevalence of vitamin D supplementation in infants aged 4 to 9 months in a tropical overseas region. Secondary objectives were to assess compliance, adherence and factors influencing vitamin D supplementation.</div></div><div><h3>Material and methods</h3><div>We conducted a cross-sectional study of infants born in La Réunion, a French overseas department in Indian Ocean. We interviewed the parents of all newborns born at term during a three-month period in 2022.</div></div><div><h3>Results</h3><div>Among the 323 term infants included, the prevalence of vitamin D supplementation at 4 to 9 months of age was 52 %. Compliance to guidelines was 44.3 %. Factors that were significantly and positively associated with vitamin D use at 4 to 9 months of age were: information about vitamin D supplementation by caregivers before leaving the maternity ward, subscription to a supplementary health insurance, and follow-up by a pediatrician. Infants whose parents reported colic and the use of supplements were significantly more likely to discontinue vitamin D supplementation</div></div><div><h3>Conclusion</h3><div>Vitamin D supplementation in these infants born in an overseas territory was not in line with current national recommendations.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 301-306"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, treatment and outcomes of acute ethmoiditis: A case series of 20 hospitalized children","authors":"Sarah Salameh ,&nbsp;Noémie Lachaume ,&nbsp;Alexandra Bisca ,&nbsp;Manon Beauvais ,&nbsp;Adrien Chaud ,&nbsp;Marie Cotillon ,&nbsp;Laure Cohen ,&nbsp;Romain Basmaci","doi":"10.1016/j.arcped.2025.04.002","DOIUrl":"10.1016/j.arcped.2025.04.002","url":null,"abstract":"<div><div>We described 20 children hospitalized with acute ethmoiditis between 2017 and 2022 in our center. Median age was 3.5 years, fifteen were Chandler’s group II and three were group III. Despite adequate antibiotic therapy regarding national antibiotic treatment guidelines, six (30 %) patients experienced poor outcomes; five of them required surgical drainage, reinforcing the need of close surveillance of these children.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 351-354"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of risk factors for developing childhood obesity in maternity","authors":"Hélène Thibault ,&nbsp;Marie Pailler ,&nbsp;Caroline Carriere ,&nbsp;Pascal Barat ,&nbsp;Mélanie Le Goff ,&nbsp;Nadira Ghemini ,&nbsp;Loic Sentilhes ,&nbsp;Muriel Rebola ,&nbsp;Vincent Rigalleau ,&nbsp;Thierry Lamireau","doi":"10.1016/j.arcped.2025.04.001","DOIUrl":"10.1016/j.arcped.2025.04.001","url":null,"abstract":"<div><h3>Background</h3><div>During the perinatal period several maternal and obstetric risk factors are known to be associated with overweight and childhood obesity.</div></div><div><h3>Method</h3><div>The aim of this study was to determine the prevalence of risk factors for childhood obesity identifiable at birth. Data extracted from the computerized medical record (DXCARE^R) women who gave birth in the maternity ward of the University hospital of Bordeaux during a 11 months-period constituted an anonymized database to calculate the prevalence of the following risk factors: maternal obesity prior to pregnancy, excessive weight gain during pregnancy, maternal smoking, gestational diabetes, low socioeconomic status, cesarean delivery, macrosomia, and lack of breastfeeding. After eliminating duplicates and women for whom data on risk factors were missing, the population available for analysis was 1977 women who responded to inclusion criteria.</div></div><div><h3>Results</h3><div>At the onset of pregnancy, mean age of women was 31.6 years [± 5.2] and mean BMI was 23.9 kg / m² [± 4.9], a third of them being overweight or obese. During pregnancy, half of women had excessive weight gain, gestational diabetes occurred in 15.9 % of them, 15.9 % smoked, and 18.1 % were in a precarious situation. Children were born by cesarean section in 15.3 % of cases. Depending on the definition used, exact birth weight (BW) or Audipog formula (percentile), neonates were large for gestational age in respectively 6.7 % of cases (BW&gt; 4000 g) or 11 % (&gt; 90th percentile) and small for gestational age in respectively 3 % of cases (BW &lt;2500 g) and 6.8 % (&lt;10th percentile). They were formula fed in 28.7 % of cases. The multivariate analysis showed that the association between excessive weight gain during pregnancy and birth weight is influenced by all other risk factors, except breastfeeding.</div></div><div><h3>Conclusion</h3><div>Risk factors for developing childhood obesity, which are largely interrelated and influenced by medical care, can be identified as early as the maternity ward. Based on their prevalence, the development of a risk score will make it possible to set up an intervention program for the early prevention of childhood obesity right from the maternity ward.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 314-321"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical implementation of the collegial decision-making procedure in case of possible unreasonable obstinacy in Neonatology","authors":"Charlotte Charbonnier ,&nbsp;Anne Bellot ,&nbsp;Grégoire Moutel ,&nbsp;Mélanie Alexandre","doi":"10.1016/j.arcped.2025.03.002","DOIUrl":"10.1016/j.arcped.2025.03.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The withholding or withdrawal of life-sustaining treatment has become the predominant cause of death in neonatal intensive care units. The advancements in perinatal medicine have led to a re-evaluation of the necessity and relevance of initiating and maintaining those treatments in patients whose conditions are not expected to improve. This decision must be made in accordance with the codified collegial decision-making process outlined in French law. In light of the shifts in end-of-life care, a review of professional practice is crucial.</div></div><div><h3>Objective</h3><div>The objective of this study was to analyze the practical implementation of the collegial decision-making process in the Neonatology Department of the Caen University Hospital. The analysis focused on three key areas: the logistical setup, the compliance with the legal framework, and the deliberation mechanisms for each collegial decision-making process. To assess the implementation of the limitation of life-sustaining treatment meetings, a variety of methods were employed, including participant observation, review of medical records, and the distribution of surveys to participants.</div></div><div><h3>Results</h3><div>In one year, 16 collegial decision-making processes were initiated, and 20 meetings were scheduled to discuss the restrictions on life-sustaining treatment. In 2 cases, the process was initiated by parents. The primary clinical condition that prompted the implementation of a collegial procedure was neurological. The presence of an external consultant was noted in 19 times. In 3 out of 20 times, parents weren't notified of their child's meeting prior to the date but all were informed of the meeting's conclusions. Data indicate a statistically significant correlation between professional category and perceived freedom to speak and legitimacy to do so, and the influence of the legal guardian's viewpoint on the participants' thinking.</div></div><div><h3>Conclusion</h3><div>The legal framework was generally respected, and the culture of service facilitated the incorporation of the collegial procedure into the habits of professionals.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 307-313"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference values for liver stiffness in children using shear-wave elastography","authors":"Célia Charlier ,&nbsp;Saskia Vande Perre ,&nbsp;Béatrice Dubern ,&nbsp;Claire Apte-Dubuisson ,&nbsp;Etienne Audureau ,&nbsp;Margaux Bertrand ,&nbsp;Hubert Ducou le Pointe ,&nbsp;Eléonore Blondiaux","doi":"10.1016/j.arcped.2025.03.006","DOIUrl":"10.1016/j.arcped.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasound shear wave elastography (SWE) measures liver stiffness non-invasively in chronic liver diseases. Reference values in healthy children by age are needed in clinical practice.</div></div><div><h3>Objectives</h3><div>Our study aimed to measure the reference values for liver elasticity by 2D SWE in a pediatric population stratified by age.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 266 children without liver disease referred for an abdominal or renal ultrasonography from February 2022 to April 2022. Shear wave elasticity and shear wave speed were measured with a convex (6C1) or linear (SL15–4) transducer with a Canon Aplio 500 Aplio system performed for another reason in healthy children aged 0 to 19 years distributed in five age groups.</div></div><div><h3>Results</h3><div>Median liver elasticity value was 5.50 kPa (interquartile range [IQR] 4.9–6.3) overall. Global analyses revealed values decreasing with increasing age from newborn to adolescence (elasticity: 6.0 kPa [IQR 5.4–6.5] to 5.3 kPa [IQR 4.7–6.4]; speed: 1.41 m/s [IQR 1.34–1.47] to 1.33 m/s [IQR 1.27–1.46], <em>p</em> &lt; 10^–3). Elasticity values were lower with the convex than linear transducer (5.20 kPa [IQR 4.7–5.8] vs 6.2 kPa [IQR 5.6–6.6], <em>p</em> &lt; 10^–4). Elasticity values increase with increasing age if we study each probe individually (from 1 year old to older). Median elasticity values were not associated with sex after adjustment for age or with BMI.</div></div><div><h3>Conclusion</h3><div>Our study provides reference values for liver elasticity in healthy children by age and for two probes using an Aplio system. Liver elasticity values differed according to the probe used.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 322-328"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residents’ perceptions of the on-call experience and of the supervision of their clinical reasoning skills in the paediatric emergency department: A qualitative study","authors":"Christine Pietrement ,&nbsp;Racha Onaisi ,&nbsp;Hubert Maisonneuve","doi":"10.1016/j.arcped.2025.03.003","DOIUrl":"10.1016/j.arcped.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>A substantial number of residents suffer from stress, anxiety, which may be acutely exacerbated by stressful situations such as being on call. When confronted with complex situations, uncertainty, a lack of medical experience, residents experience a mismatch between their theoretical knowledge and their clinical reasoning skills. In a previous study we observed high levels of cognitive weariness and anxiety in residents being on call in the paediatric emergency department, and the reduction of their cognitive weariness by training clinician-educators in the supervision of clinical reasoning.</div></div><div><h3>Objectives</h3><div>Thereafter we sought to inform the findings of our previous quantitative research by exploring in depth the experience of on-call residents in the paediatric emergency department, including: the factors that impact their well-being, and how supervision of their clinical reasoning might change it.</div></div><div><h3>Methods and Setting</h3><div>We performed a qualitative study using semi-structured interviews. We interviewed medical residents who were on call in the paediatric emergency department, mentored by paediatricians who had received specific training in the supervision of clinical reasoning.</div></div><div><h3>Results</h3><div>The findings revealed two opposing profiles of how residents experience being on call and having their clinical reasoning supervised. First, there were those who expressed marked discomfort, characterized by anxiety, a strong need for supervision, a fear of being judged by the supervisor, and a major impact of physical fatigue. Residents with this profile seem to be at risk of developing burnout, or symptoms thereof. The second profile of residents expressed little unease, had a sense of self-efficacy, a feeling of personal competence, a high level of self-confidence, greater tolerance of uncertainty, and little difficulty with making decisions.</div></div><div><h3>Conclusions</h3><div>Supervision of clinical reasoning based on questioning techniques seems to participate to promote development towards second profile, with greater tolerance of uncertainty, ease with decision-making, and a reinforced sense of belonging to a team.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 335-343"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"French childminder knowledge of pediatric guidelines for screen use: An observational study","authors":"C. Allet ,&nbsp;M. Samaille ,&nbsp;A.D. Marq ,&nbsp;M. Bailhache","doi":"10.1016/j.arcped.2025.05.005","DOIUrl":"10.1016/j.arcped.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>Early, excessive, and inappropriate screen exposure has negative short- and long-term effects on children. In France, registered childminders are the main source of childcare.</div></div><div><h3>Objective</h3><div>To explore childminder knowledge of the pediatric guidelines for screen use and the potential negative effects on children.</div></div><div><h3>Participants and Setting</h3><div>Registered childminders working in the French department of Gironde who had email accounts.</div></div><div><h3>Methods</h3><div>The maternal and child health services unit of the Gironde department distributed an anonymous online questionnaire from January 24, 2023, to February 19, 2023. Data were collected on childminder characteristics, personal screen use practices, knowledge of potential negative effects of inappropriate screen use, and knowledge of best practice recommendations for screen use. A knowledge score ranging from 0 (all wrong) to 14 (good) was constructed.</div></div><div><h3>Results</h3><div>A total of 1102 registered childminders participated; the median knowledge score was 9 with an InterQuartile Range of [7.5, 10.5]. A total of 95.2 % agreed that screen use should be avoided before the age of three. A minority of childminders, 13.4 % and 23.1 %, respectively, had good answers for possible short—and long-term negative effects. Childminders younger than 50 years with less experience and those who tend to use screens more had better knowledge than the others.</div></div><div><h3>Conclusions</h3><div>French childminders interviewed in Gironde have relatively good knowledge of pediatric guidelines for screen use.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 329-334"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}